Crisis Standards of Care Planning

Disasters can stress health care systems to the breaking point and disrupt delivery of vital medical services. In such situations, medical care must promote the use of limited resources to benefit the population as a whole.

In 2009, at the request of the federal government, the Institutes of Medicine (now the National Academies of Sciences, Engineering, and Medicine) formed a committee to develop guidance that health officials could use to establish and implement standards of medical care during disasters. This committee defined crisis standards of care (CSC) as “a state of being that indicates a substantial change in health care operations and the level of care that can be delivered in a public health emergency, justified by specific circumstances.”

The need for CSC has been recognized within Illinois as an essential component of disaster planning/preparedness. This has prompted a collaborative initiative by the Illinois Department of Public Health (IDPH) and the Chicago Department of Public Health (CDPH), under the auspices of their Hospital Preparedness Program activities.

CSC planning is a challenging and complex process requiring a multi-year approach. The overall goal of this project is to develop a Crisis Standards of Care Plan that has been vetted through a public engagement process, and that addresses crisis standards, allocation of scarce resources and ethical decision making in a resource constrained medical environment. The following is a brief summary of the timeline of activities for the State of Illinois.

  • Spring of 2013
    • Initial planning meeting convened with CDPH, IDPH and MCHC-Chicago Hospital Council, an affiliate of the Illinois Hospital Association (IHA), to develop a Core Planning Group comprised of public health and hospital representatives, inclusive of both urban and rural perspectives.
  • 2014-2015
    • CSC Core Planning Group created five subcommittees: Ethics; Legal; Hospitals & Healthcare; EMS & Public Safety and Public Health. These subcommittees are tasked with examining the challenges of Crisis Standards of Care from their  discipline-specific perspectives.  The Ethics and Legal Subcommittees will each develop guidelines and provide feedback on the respective areas of ethical and legal issues surrounding Crisis Standards of Care.  The Hospitals and Healthcare, EMS & Public Safety, & Public Health subcommittees will examine the various indicators and triggers of crisis standards of care for their disciplines.
    • It also conducted a series of stakeholder engagement meetings throughout the State, utilizing a qualitative analysis methodology to gather and analyze input on health care priorities during disaster situations.The stakeholder engagement meetings were focused on gathering input from medical providers on their perspective on the challenges and issues of providing healthcare in a catastrophic disaster situation.
  • 2016
    • Launch the “Healthcare in Disaster Situations: Your Voice Matters” series of community engagement meetings across the State of Illinois to gain input from communities on crisis standards of care, including allocation of scarce resources and ethical decision making in a resource constrained medical environment.
      • 9 statewide meetings
        • May 25, 2016 – Peoria (2 meetings)
        • May 26, 2016 – Springfield
        • June 21, 2016 – Chicago
        • June 22, 2016 – Kankakee
        • June 23, 2016 – Champaign
        • June 24, 2016 – Rockford
        • June 27, 2016 – Effingham
        • June 28, 2016 – Carterville
        • June 29, 2016 – Metropolis

2017

  • Drafted the Catastrophic Incident Response Annex (CIR)
    • This plan provides a functional annex for all stakeholders involved in an emergency response within the State of Illinois and/or adjacent states in order to provide crisis care to patients in Illinois during a catastrophic incident.
  • Continued “Healthcare in Disaster Situations: Your Voice Matters” community engagement meetings.
    • 20 statewide meetings
      • Members of the public who are interested in participating in upcoming meetings for the “Healthcare in Disaster Situations: Your Voice Matters” community engagement initiative are encouraged to visit the following website for details and registration: https://disasterfeedback.eventbrite.com

Additional Resources

In the Event of Real Emergency or Disaster Events, Contact CDPH PHEOC.
P: 312-742-7921